Perinatal mortality: epidemiological profile, causes and avoidable factors at a reference public maternity hospital in the State of Santa Catarina, Brazil, 2011–2015
-
Carla Beatriz Pimentel Cesar Hoffmann
,
Lidiane Ferreira Schultz
Abstract
Background
This study aimed to identify the perinatal mortality coefficient, the epidemiological profile, causes and avoidable factors at a reference public maternity hospital in southern Brazil.
Methods
In this cross-sectional study, 334 medical records of postpartum women and newborns were evaluated between January 1st, 2011 and December 31st, 2015. The Expanded Wigglesworth Classification was used to assess the causes of perinatal mortality and the International Statistical Classification of Diseases and Related Health Problems (ICD-10/SEADE Foundation) was used for the preventable perinatal mortality analysis. Absolute numbers and percentages were used for data analysis. The perinatal mortality formula was used to calculate the perinatal mortality rate.
Results
The perinatal mortality rate was 13.2/1000 total births, with a predominance of white race/color; mothers were 21–30 years of age, had experienced their first pregnancy and had completed their high school education.
Conclusion
The main factors associated with perinatal death were antepartum fetal death in 182 (54.49%) cases, and avoidable death through appropriate prenatal care in 234 (70.05%) cases.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Conflict of interests: None declared.
References
1. Sobieray NLEC, Urbanetz AA, Tristão EG. Estudo da mortalidade perinatal do município de Curitiba no período de 2002 a 2005. Arq Med Hosp Fac Cienc Med Santa Casa São Paulo 2015;60:47–53.Search in Google Scholar
2. Lansky S, Friche AAL, da Silva AAM, Campos D, Bittencourt SDA, Carvalho ML, et al. Pesquisa Nascer no Brasil: perfil da mortalidade neonatal e avaliação da assistência à gestante e ao recém-nascido. Cad Saúde Pública 2014;30(Suppl 1):S192–207.10.1590/0102-311X00133213Search in Google Scholar PubMed
3. Unites Nations. The Millennium Development Goals Report 2015. New York, 2015. http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf. Accessed: January 11, 2018.Search in Google Scholar
4. França EB, Lansky S, Rego MAS, Malta DC, França JS, Teixeira R, et al. Principais causas da mortalidade na infância no Brasil, em 1990 e 2015: estimativas do estudo de Carga Global de Doença. Rev Bras Epidemiol 2017;20:46–60.10.1590/1980-5497201700050005Search in Google Scholar PubMed
5. Brasil. Ministério da Saúde. Secretaria de Ciência, Tecnologia. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. Síntese de evidências para políticas de saúde: mortalidade perinatal, 2. ed. Brasília: Ministério da Saúde, 2015:40. bvsms.saude.gov.br/bvs/publicacoes/sintese_evidencias_mortalidade_perinatal.pdf.s.Search in Google Scholar
6. Aminu M, Mathai M, van den Broek N. Application of the ICD-PM classification system to stillbirth in four sub-Saharan African countries. PLoS One 2019;14:e0215864.10.1371/journal.pone.0215864Search in Google Scholar PubMed PubMed Central
7. Brasil. Ministério da Saúde. Rede Interagencial de Informações para a saúde. Indicadores de mortalidade perinatal. Accessed: September 2018. http://tabnet.datasus.gov.br/cgi/idb2000/fqc05.htm.Search in Google Scholar
8. Organização Mundial da Saúde. Classificação estatística internacional de doenças e de problemas relacionados à saúde. Décima revisão. Manual de instrução (volume 2). São Paulo: Centro Colaborador da OMS para a Classificação de Doenças em Português; 1994.Search in Google Scholar
9. Mukherjee SB, Bandyopadhyay T. Perinatal mortality – what has changed? Indian Pediatr 2016;53:242–3.10.1007/s13312-016-0828-xSearch in Google Scholar PubMed
10. OECD. Organization for Economic Co-operation and Development. OECD Health Statistics 2017; June 2017. Accessed: September 2018. http://www.oecd.org/els/health-systems/health-data.htm.Search in Google Scholar
11. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Secretaria de Atenção à Saúde. Manual de vigilância do óbito infantil e fetal e do Comitê de Prevenção do Óbito Infantil e Fetal/Ministério da Saúde, Secretaria de Vigilância em Saúde, Secretaria de Atenção à Saúde. – 2ª Ed. – Brasília: Ministério da Saúde, 2009. 96 p.: il. – (Série A. Normas e ManuaisTécnicos). bvsms.saude.gov.br/…/vigilancia_obito_infantil_fetal.pdf.Search in Google Scholar
12. Allanson ER, Tunçalp Ö, Gardosi J, Pattinson RC, Francis A, Vogel JP, et al. The WHO application of ICD-10 to deaths during the perinatal period (ICD-PM): results from pilot database testing in South Africa and United Kingdom. BJOG 2016;123: 2019–28.10.1111/1471-0528.14244Search in Google Scholar PubMed
13. Brasil. Secretaria Municipal de Saúde. Relatório Anual da Gestão 2014. Joinville: Secretaria Municipal de Saúde; 2014. Accessed: December 4, 2017. https://www.joinville.sc.gov.br/…/Plano-Municipal-de-Saúde-do-Município-de-Joinville.Search in Google Scholar
14. Brasil. Ministério da Saúde. Iniciativa hospital amigo da criança: revista, atualizada e ampliada para o cuidado integrado. Módulo I – Histórico e implementação [Internet]. Brasília: Editora do Ministério da Saúde; 2008 [cited 2008 Sept 10]. (Série A. Normas e Manuais Técnicos). Available at: http://bvsms.saude.gov.br/bvs/publicacoes/iniciativa_.Search in Google Scholar
15. Santa Catarina. Secretaria Estadual de Saúde de. Maternidade Darcy Vargas, de Joinville, recebe prêmio nacional Hospital Amigo da Mulher. Publicado em 23 de maio de 2016. http://portalses.saude.sc.gov.br/index.php?option=com_content&view=article&id=5241:maternidade-darcy-vargas-de-joinville-recebe-premio-nacional-hospital-amigo-da-mulher&catid=1311:ascom-assessoria-de-comunicacao-2016. Accessed December 11, 2017.Search in Google Scholar
16. Lansky S, França E, Leal MC. Mortalidade perinatal e evitabilidade: revisão da literatura. Rev. Saúde Pública 2002;36:759–72.10.1590/S0034-89102002000700017Search in Google Scholar
17. Dias BAS, Santos NET, Andrade MAC. Classificações de evitabilidade dos óbitos infantis: diferentes métodos, diferentes repercussões? Cad. Saúde Pública 2017;33:e00125916.10.1590/0102-311x00125916Search in Google Scholar PubMed
18. Organização Mundial da Saúde. Classificação estatística internacional de doenças e de problemas relacionados à saúde. Décima revisão. Manual de instrução (volume 2). São Paulo: Centro Colaborador da OMS para a Classificação de Doenças em Português; 1994.Search in Google Scholar
19. SEADE. Fundação Sistema Estadual de Análise de Dados. Mortalidade Infantil e desenvolvimento. Conj Demogr 1991;14/15:49–50.Search in Google Scholar
20. Berhan Y, Berhan A. Perinatal mortality trends in Ethiopia. Ethiop J Health Sci 2014;24(0 Suppl):29–40.10.4314/ejhs.v24i0.4SSearch in Google Scholar PubMed PubMed Central
21. Ntambue AN, malonga FK, Dramalx-Wilmet M, Ngatu RN, Donnen P. Better than nothing? Maternal, newborn, and child health services and perinatal mortality, Lubumbashi, democratic republic of the Congo: a cohort study. BMC Pregnancy Childbirth 2016;16:2–12.10.1186/s12884-016-0879-ySearch in Google Scholar PubMed PubMed Central
22. MacDorman MF, Gregory ECW. Fetal and perinatal mortality: United States, 2013. National vital statistics reports; vol. 64 no 8. Hyattsville, MD: National Center for Health Statistics; 2015.Search in Google Scholar
23. Office for National Statistics. Childhood mortality in England and Wales: 2015. www.europeristat.com. Accessed: July 19, 2017.Search in Google Scholar
24. Donoso SE. Está aumentando La mortalidad perinatal em Chile? Rev Chil Obstet Ginecol 2011;76:377–9.10.4067/S0717-75262011000600001Search in Google Scholar
25. Cortés DPB, Rivas DC. Caracterización de la mortalidad perinatal em Manizales, Colombia, 2009–2012. Hacia Promoc Salud 2014;19:66–80.Search in Google Scholar
26. Flores LPO. A Mortalidade Perinatal no Brasil. In: Congresso Nacional de Estudos Populacionais. Anais do XVIII Congresso Nacional de Estudos Populacionais. Abep. 2012;3:200–15.Search in Google Scholar
27. Brasil. Ministério da Saúde. Indicadores de mortalidade. C.2 Taxa de mortalidade perinatal. Acesso em 10 de junho de 2017. http://tabnet.datasus.gov.br/cgi/idb2012/c02b.htm.Search in Google Scholar
28. Flenady V, Frøen JF, Pinar H, Torabi R, Saastad E, Guyon G, et al. An evaluation of classification systems for stillbirth. BMC pregnancy and childbirth. BMC Pregnancy Childbirth 2009;9:24.10.1186/1471-2393-9-24Search in Google Scholar PubMed PubMed Central
29. Reis AP, Rocha A, Lebre A, Ramos U, Cunha A. Perinatal mortality classification: an analysis of 112 cases of stillbirth. J Obstet Gynaecol 2017;37:835–9.10.1080/01443615.2017.1323854Search in Google Scholar PubMed
30. Donoso SE. ¿Está aumentando La mortalidad perinatal em Chile? Rev Chil Obstet Ginecol 2011;76:377–9.10.4067/S0717-75262011000600001Search in Google Scholar
31. Gaiva MAM, Fujimori E, Sato APS. Mortalidade neonatal em crianças com baixo peso ao nascer. Rev Esc Enferm USP 2014;48:778–86.10.1590/S0080-6234201400005000002Search in Google Scholar
32. Molina S, Alfonso DA. Muerte fetal anteparto: ¿es una condiciónprevenible?/Fetal deathsyndrome: could it beprevented? Univ Med 2010;51:59–73.10.11144/Javeriana.umed51-1.mfaeSearch in Google Scholar
33. Caldeira AP, França E, Perpétuo IHO. Evolução da mortalidade infantil por causas evitáveis, Belo Horizonte, 1984–1998. Rev Saúde Pública 2005;39:67–74.10.1590/S0034-89102005000100009Search in Google Scholar
34. Fonseca SC, Coutinho ESF. Características biológicas e evitabilidade de óbitos perinatais em uma localidade na cidade do Rio de Janeiro, 1999 a 2003. Rev Bras Saúde Mater Infant 2008;8:171–8.10.1590/S1519-38292008000200004Search in Google Scholar
35. Malta DC, Duarte EC. Causas de mortes evitáveis por ações efetivas dos serviços de saúde: uma revisão da literatura. Ciênc Saúde Coletiva 2007;12:765–76.10.1590/S1413-81232007000300027Search in Google Scholar PubMed
36. Brasil. Ministério da Saúde. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. Síntese de evidências para políticas de saúde: mortalidade perinatal. – Brasília: Ministério da Saúde; 2012:43. – (Série B. Textos Básicos de Saúde). bvsms.saude.gov.br/bvs/publicacoes/sintese_evidencias_mortalidade_perinatal.pdf.Search in Google Scholar
©2020 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review
- Variations in long-term outcome reporting among offspring followed up after lifestyle interventions in pregnancy: a systematic review
- Corner of Academy
- Modifiable risk factors for spontaneous preterm birth in nulliparous women: a prospective study
- Additional benefits of three-dimensional ultrasound for prenatal assessment of twins
- Original Articles – Obstetrics
- Microbial burden and inflammasome activation in amniotic fluid of patients with preterm prelabor rupture of membranes
- Amniotic fluid concentrations of soluble endoglin and endothelial cell-specific molecule-1 in pregnancies complicated with neural tube defects
- Maternal characteristics and pregnancy outcomes of women with chronic hypertension: a population-based study
- Behavior of fetal longitudinal myocardial fibers assessed by speckle tracking to obtain strain and strain rate values for low-risk pregnancies
- The effect of a scheduled regimen of acetaminophen and ibuprofen on opioid use following cesarean delivery
- Original Articles – Fetus
- Comparison of cord blood lactate measurement by gas analyzer and portable electrochemical devices
- Perinatal mortality: epidemiological profile, causes and avoidable factors at a reference public maternity hospital in the State of Santa Catarina, Brazil, 2011–2015
- Original Articles – Newborns
- Maternal smoking and cannabis use during pregnancy and infant outcomes
- The utility of cranial ultrasound as a screening tool for neonatal ECMO
- Effects of human milk fortifier properties on intrinsic probiotic bacteria
- Letter to the Editor
- Superb microvascular imaging with Doppler luminance using an 18-MHz probe to visualize fetal intra-abdominal blood vessels and organ microvasculature
Articles in the same Issue
- Frontmatter
- Review
- Variations in long-term outcome reporting among offspring followed up after lifestyle interventions in pregnancy: a systematic review
- Corner of Academy
- Modifiable risk factors for spontaneous preterm birth in nulliparous women: a prospective study
- Additional benefits of three-dimensional ultrasound for prenatal assessment of twins
- Original Articles – Obstetrics
- Microbial burden and inflammasome activation in amniotic fluid of patients with preterm prelabor rupture of membranes
- Amniotic fluid concentrations of soluble endoglin and endothelial cell-specific molecule-1 in pregnancies complicated with neural tube defects
- Maternal characteristics and pregnancy outcomes of women with chronic hypertension: a population-based study
- Behavior of fetal longitudinal myocardial fibers assessed by speckle tracking to obtain strain and strain rate values for low-risk pregnancies
- The effect of a scheduled regimen of acetaminophen and ibuprofen on opioid use following cesarean delivery
- Original Articles – Fetus
- Comparison of cord blood lactate measurement by gas analyzer and portable electrochemical devices
- Perinatal mortality: epidemiological profile, causes and avoidable factors at a reference public maternity hospital in the State of Santa Catarina, Brazil, 2011–2015
- Original Articles – Newborns
- Maternal smoking and cannabis use during pregnancy and infant outcomes
- The utility of cranial ultrasound as a screening tool for neonatal ECMO
- Effects of human milk fortifier properties on intrinsic probiotic bacteria
- Letter to the Editor
- Superb microvascular imaging with Doppler luminance using an 18-MHz probe to visualize fetal intra-abdominal blood vessels and organ microvasculature
